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Archive for the ‘Employer Issues’ Category

Although Unum goes through regular seasonal rounds of firings and terminations, recent company lay-offs and terminations are hitting high levels of anger and frustration from former employees.

There is no secret that something is going on at Unum. Continuous negligence in the form of losing paperwork, adjudicating the wrong policy or Plan, not reading claim files, incompetence of claims handlers, accelerated unfair claims practices and lack of customer service, are being widely reported by those who have claims with the company.

In the midst of growing incompetence, reports indicate the company is laying off claims personnel (Worcester in particular) but is also terminating employees using many of the same trumped-up allegations of misusing company phones.

Over the last several years it has been reported to DCS that Unum often alleges “misuse of company phones and data plans” to terminate employees. One now ex-employee informed us that Unum fired her because she called a claimant from her cell phone. Another terminated employee reported that Unum obtained access to her personal calls and alleges she was working from that phone and exceeded the data plan.

I’m sure Unum employees must be aware that if Unum provides a cell phone and pays for a data plan that the company has access to complete call records and data plan usage. I think I’d be tempted to not call such a phone a “perk” but instead put it in a drawer and forget about it. Knowing Unum could spy on my calls would make me extremely nervous.

Nevertheless, Unum often uses “the phone” to terminate employees, particularly when “poor performance” won’t stick. Unum employees should be keeping diaries, journals, emails, and other records noting names, dates and places of activities that takes place within the company. This information should be kept off-site since Unum will confiscate any records or files you have at your desk when you are escorted to the door.

Most Human Rights Commissions and EEOC complaints should be backed up with “evidence” of discrimination of age and gender when those situations apply. The agencies mentioned with always ask, “What evidence do you have to back up your claims?”

Employees who use STD, or who take FLMA leave report they are “punished” for using benefits they are entitled to and are terminated for small indiscretions. Terminated employees report their personnel files have been sanitized and paperwork is missing.

The final blow for terminated employees is Unum’s refusal to allow the payment of unemployment, and in some cases, severance. DCS recommends that any employee who has been laid-off or terminated should seek the advice of an employment attorney to make sure Unum pays all that you are entitled to.

I have always said that getting fired from Unum is the best thing that will ever happen to you. Although at first Unum might seem like a good opportunity, the company is really a train wreck.

Whatever the company forces you to do to insureds and claimants, it can also do to you.

For now, however, Unum continues to lay-off and terminate employees at a time when in the public’s eye the company appears to be chaotic, and in complete disarray. Moving its IT divisions to India probably won’t help since employees report extremely out-dated technology, computers, and software are being used. Obviously, Unum hasn’t kept up with state of the art hardware to process claims.

Customers, insureds and claimants, always suffer the consequences of Unum mismanagement and negligence, and it isn’t getting any better. Perhaps Unum should consider putting itself out of its misery by merging with a more successful company.

 

 

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Getting FiredCalls and messages from Unum’s recently terminated employees seems to indicate the company launched again headlong into firing employees for minor infractions, some they didn’t even know about.

Didn’t record a flup? Took no action on a flup (follow-up)? Used cell phone? Can’t handle the block of claims and new business? Poor history of claim denials? Guess what? You’re gone!

It’s wishful thinking for any Unum employee to believe they have job security. Some employees who are suddenly terminated are those who received generous salary increases and spot performance awards months before terminations take place. Still, Unum alleges employees are “not able to maintain standards” and they are fired for “poor performance.”

Whether or not the job infractions warrant “termination” is usually determined by claims managers who “want to get rid of” direct reports who aren’t holding up their commitment to processing denials.

Employees who have been on the job for more than 20 years and are “getting of age” are also targeted as quick hit terminations, again for poor performance. Employees with “Meets” performance ratings are  suddenly terminated making one wonder whether anyone in the company is actually performing well.

Although any employer can terminate an employee for little to no reason, Unum actually works very hard at it. It spends time padding the employee’s file with probations, and negative reports for minor things such as “not bolding certain contractual words in policy citations”, or failing to record a flup as completed, etc.

Managers discuss “poor performance” issues with peers to create “hate groups” within the unit that ostracize employees making work environments unbearable.  I’ve often wondered whether other employees realize the extent to which Unum uses them against their peer workers.

Although I have never criticized any Unum claims rep for doing what is necessary to keep their job, it has become increasingly clear in the last year that not only are Unum’s employees complicit with Unum’s unfair practices, but actively seek to deny claims in order to receive annual bonuses held over their heads by management.

Although Unum’s bonuses may appear to be significant, the amount of each individual bonus to claims handlers is probably less than $3,000. What would you be willing to do for $3,000?

My message to Unum claims handlers is to consider that whatever the company can do to its insureds and claimants, it can just as easily do to you, and it does.

And, by the way, Unum can’t control what you do, or who you talk to after it walks you to the door. In some instances via letters Unum tries to tell you not to speak to anyone about the company if you want to get your “severance” money. Once Unum terminates your employment it cannot dictate what you do or who you speak to. You do not have to be afraid.

Believe it or not, there IS life after Unum. You may be hurt and angry at having been fired but in the long run, not working for Unum is preferable to cutting off someone’s legitimate benefits you know should have been paid.

There are many employers who treat their employees with respect by providing leadership and opportunities for advancement. Unum is not one of them – instead, the company sends you to Disneyland to “aspire” more indoctrination and assumes adult employees want a hug from Mickey Mouse.

Sometimes getting fired opens more doors than it closes. I am always available to terminated Unum employees who need someone to talk to. DCS refers Unum employees to good employment attorneys to determine if they are getting what they are entitled to such as unemployment, severance, and/or retirement.

Employment termination by a company scorned by the public with a history of unfair claims review can’t be such a bad thing. Sometimes it’s the best thing that ever happened to you!

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You're Fired2In the past, I’ve written several blogs expounding on Unum’s mistreatment of its employees. Although these posts receive very little sympathy from insured readers, the fact that I receive verification from reliable sources as to what Unum’s claims practices are, is important to us all.

It’s clear from the information reported to me that Unum is currently conducting its claim reviews in the same manner as prior to the multi-state settlement agreement.  (I might even suggest the claims process appears to be worse.) It’s no secret that Unum operates in violation of the agreement and regulators place no accountability on Unum to comply.

Pressure continues to be put on Unum’s claims specialists to locate and target claims by month, quarter or year-end. One former claims handler told DCS that her manager contacted her as many as 13 times in 3 hours checking on files she targeted and expected to be denied. The push to deny claims continues to place tremendous stress on Unum’s staff, often causing health issues.

Apparently, Unum has a great deal of management turnover when managers leave to “find opportunities outside of the company.” However, the “opportunities’ referred to result in transitions to Guardian and MetLife which is probably why Unum’s unfair practices appear to be popping up with other insurers.

However, frequent management turnovers also prompt Unum to promote unqualified “lead specialists” to director positions simply because they have the “know-how to deny claims quickly.” Unum always did have a leadership problem, and promotes employees based, not on their management or people skills, but on the ability to deny claims indiscriminately.

Certain Unum managers are insisting that conference calls be made to SSA so that claims specialists can find out more detailed information (diagnostic codes) from SSDI DDS’. Remember, claimants are included in the call so that he/she can respond to the specific “prompts” and “get the Unum specialist in” to ask questions. Do I need to advise insureds not to agree to this procedure?

It is also reported to me that other managers literally stalk, LinkedIn, Facebook and YouTube looking at pictures and posts. Actually, LinkedIn allows members to see who is looking at them, so it shouldn’t be a big secret when a Unum manager “links in.” DCS has always recommended that its clients stay off of social media entirely for this reason.

Unum continues to abuse the claims process by “talking insureds and claimants” in to Advance Pay and Close agreements. According to recent information, most insureds who initially accept these agreements are forced to come back on claim, but Unum reps overburden the process by requiring more and more medical evidence before claims are paid again. (I’ve written about AP&Cs before and I continue to recommend caution.)

It has also been communicated to me recently that internally, Unum claims reps have no shame about what they are doing and continue to target and deal harshly with behavioral health, migraine, vertigo, Parkinson’s or dementia claims. It reminds me of the Facebook post a Unum manager wrote, “Claimants are like Slinkys. They aren’t worth that much, but you like to see one tumble-down the stairs every once in a while.”

There’s no question but that Unum claims reps are more than aware of what’s going on particularly when asked to sign letters they don’t write, or communicate claims decisions they don’t agree with.

When a Unum manager decides to “fire” an employee the same things seem to happen:

  • Mangers pad personnel files with errors and mistakes that are considered trivial when committed by employees in good standing. Failure to copy email documents into the claim file, mislabeling claim documents, failure to document voice mails received, using one’s iPhone to contact insureds etc. I’m sure Quality Compliance also gets into the act somewhere and “conducts investigations” scaring the hell out of claims reps who are struggling to keep their jobs.
  • Targeted employees are deliberately not promoted, are prevented from mentoring others, and are even locked out of their computers.
  • Management separates the claims rep in question from unit peers by sharing performance issues with others to create mistrust and social issues that ostracize the employee from their peer support groups.
  • HR cooperates (Sandra Rosen) and stabs the employees in the back eventually. It is very unwise to trust Unum HR in any matter.
  • Management assigns increased workloads to the employee deliberately causing performance failure, and more documentation of failures to perform job expectations.
  • Managers often physically remove the employee from the unit area further separating the employee from being a part of the unit. (This is a very cultish practice wouldn’t you say?)
  • Once terminated, Unum often fights the approval of unemployment benefits, severance pay, and other employee benefits the claims rep might have otherwise been entitled to.
  • The day of termination (usually a Friday), the employee is escorted to the door by security and is not allowed to take anything from their desks. In fact, Unum prefers to terminate employees off-campus. One employee who was terminated in Chattanooga was told to pick up her personal belonging at the curb of the Unum building at 5:00 to further humiliate her. This is why DCS recommends to Unum claims handlers that they keep a copy of all documents at home.

Most Unum claim employees walk around with a “Your Fired” sticky on their head whether they know it or not. But, there is good news….there is life after Unum. Transitioning to another insurance company may not be the answer because all insurers now copy Unum’s practices. There ARE employers out there who will treat their employees decent.

The bottom line here is that at least according to its own employees, Unum is an egregious, unfair insurer and nearly everyone associated with it has the potential of being harmed. This is a message that group STD/LTD employers need to hear loud and clear.

My door is always open to Unum employees who may need a caring ear to listen. I’ve been there, and I know what it feels like to be abused by Unum. There are many employers out there who will treat you with respect in accordance with your levels of skill, education and experience.

In my opinion, it’s also no secret that Unum targets claims and pushes its staff to deny as many of them as possible prior to a profit reporting period. The company’s claims practice is corrupt, and most Unum claims handlers are out front with insureds and claimants protecting managers who are the real culprits.

While I’m sorry to hear that Unum is once again terminating employees in another round of firings, it may not be such a bad idea for employees to move on to employers outside the insurance industry who are more respectful.

For insureds and claimants, we have the benefit of validation of Unum’s abusive claims practices communicated to us by those who know.

 

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BAd phone callsI don’t know how many times claimants have told me, “My employer is the best, and they’ve been so supportive!” When I hear comments like this I mentally add, “As far as you know.” While employers may initially communicate how sympathetic they are to your disability, employer concern generally takes a 360 once employees transition to LTD.

Although ERISA employer-provided disability Plans provide group disability coverage, employees are not direct parties to the Plan contract and are considered “certificate holders.” Employees are the beneficiaries of benefits, but the two parties to the Plan are employers and insurers. This is why employees are only provided with SPDs (Summary Plan Descriptions) and “Certificate Booklets” rather than official copies of Plan Documents.

Some employers “self-insure” STD and pay insurers as “third-party administrators” (TPAs), who render “advice to pay or deny” (ATP). Employers assume the liability to pay STD and can refuse the advice of the insurance company to deny and pay claims anyway. Not all employers choose to self-insure STD, but a growing number of companies greater than 2,000 lives are now doing it.

Since employers and insurers are parties to the Plan policy, information flows back and forth between these two sources on a regular basis, although there are some rules regarding the sharing of medical information. Those employers who “self-insure” STD have access to medical information since it is the employer who actually pays benefits to employees. Employers also see completed FMLA paperwork, including the medical section, and keep it on file.

Beyond STD, however, employers should have no direct access to medical or medical claim information about their employees. Although insurers are supposed to respect the privacy of claimants’ medical information by omitting references to impairment in letters, there is no protection as to what is said on the phone between employer and insurance companies. Who would know?

The important thing to remember is that since employers and insurers are the two parties to Plan policies, there is a continual exchange of information officially and unofficially between the two. Copies of all communications sent to claimants from insurers are also provided to employers supposedly omitting any references to medical conditions.

Employees who get themselves into trouble are those who attempt to maintain employer relationships beyond STD and continually “spill the beans” about every aspect of their medical conditions to HR reps who in turn repeat everything that is said back to the insurance company and vice versa. Not a good idea.

Employers who initially treated disabled STD employees with respect are now hastily waiting out the 12 week FMLA period so that termination letters can be sent. Very few employers are willing to offer workplace accommodations beyond the 12-week FMLA period.

Disabled workers are not required to share every aspect of their medical disabilities with employers, and in fact it is a mistake to do so. Again, although employers and HR reps are initially sympathetic and helpful, employers’ good graces rarely last beyond the 12 weeks of FMLA.

By the way, HR reps are not there to make sure the “going out on disability” system is fair to employees. HR reps are involved in the management of disability to protect the interests of EMPLOYERS and ensure there are no potential causes of legal action. Employees should never trust that HR reps have their best interests at heart because they do not. Every word that is said, every comment made, every conversation that takes place is communicated back to insurers.

A good case in point happened to a worker who went out of work due to chronic back problems. One day, she was seen by a former peer worker lifting cases of soda into the trunk of her car. This information was reported to an HR rep who promptly called Unum and reported the incident. Unum then began an investigation and eventually denied the claim. It was later charged that the peer who reported the incident “didn’t like” the insured and misstated what she saw.

It is extremely important for claimants to understand the difference between information communicated that is “need to know” and other information communicated as attempts to defend claims as credible. Some employees will share information with employers that is adverse to payment of claims because they feel the need to convince someone their claims are credible.

DCS advises against sharing any information with employers that is not “need to know” in order to process any disability claim. Although employers may give claimants all of the support they need during STD, it rarely continues if employees are unable to return to work.

I’ve attended too many Unum account sales meetings and listened to employers expound on the fact they don’t want to keep employees on claim if they can’t come back to work. Sometimes employers speak out of both sides of their mouths when it comes to what they really want out of a group disability Plan.

Remember always that all information communicated to employers eventually winds up on the insurance company’s desk and vice versa.

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Age DiscriminationUnum’s reputation for terminating older, usually female workers is widespread. As a former Unum employee I can certainly attest to the fact that Unum fires middle-aged women under the guise of “poor performance.” Newly hired employees are remarkably younger.

One of my clients recently told me his “elder Unum claims handler” was also terminated for no reason. In my opinion, it’s no secret that Unum terminates middle-aged men and women and those who begin to have health problems.

The Maine Human Rights Act, ME Rev. Stat. Tit. 5 Section 4572, prohibits discrimination in employment based on age. This Act covers all of the employers in the state, including employment agencies and labor unions.

It is unlawful in the state  for employers to engage in the following:

  • Fail, refuse to hire, or otherwise discriminate against any  applicant for employment because of age.
  • Discharge, or discriminate with respect to hiring, tenure, promotion, transfer, compensation, terms, conditions, or privileges of employment based on age.
  • Use an employment agency that the employer knows or has reasonable cause to know discriminates against individuals because of age.
  • Exclude applicants or employees from apprenticeship or other training programs because of age without permission of the Maine Human Rights Commission.
  • Elicit or attempt to elicit information, directly or indirectly pertaining to age.
  • Make or keep a record of an applicant’s or employee’s age, or use any form of application containing questions or entries directly or indirectly pertaining to age.
  • Print or publish any notice or advertisement relating to employment indicating any preference, limitation, specification, or discrimination based on age.
  • Establish, announce or follow a policy of denying or limiting employment because of age, through a quota system (or pattern of practice?).

Unum gets away with many of its employment practices by “padding files” with adverse information regardless how petty, and alleging employees are incapable of doing jobs assigned to them. The official reason for termination is “poor performance” after a period of “probation warnings” and frequent “talking to.”

What I found particularly awful is that Unum’s management “confides” in peers about employee poor work habits and eventually everyone in the Unit is giving selected employees the cold shoulder. Employees begin to feel ostracized and abandoned by the team.

In addition, Unum’s legal department solicits emails from unit peers that employees may have sent from home in order to support the cause of termination. Of course “friends” give up the emails under threat of termination themselves making it impossible to trust anyone you work with.

Managers have been known to assign projects they know employees won’t have time to do, and pad personnel files with multiple adverse information such as “closing a flup without taking any action on it.” (This was a fairly recent report to me from a Unum employee terminated for closing out flups without noting anything was done.)

Over 45 years old seems to be the target age for Unum managers to begin the trail of “poor performance” without any reason. Middle aged women who are not among the political “in crowd” with managers suddenly can’t do anything right and are constantly criticized for their job performance.

DCS recommends to Unum’s middle-aged employees in Maine that they keep journals, diaries and accumulate 1/1 emails and records of nearly everything that happens, jobs and projects assigned etc. so that a complaint can be made to the Maine Human Rights Commission should Unum terminate employment due to age or gender discrimination.

Unum employees in MA and TN should look up age and gender discrimination laws that apply in those states.

I’ve included the link below with more specific information for Maine Unum employees.

http://www.mainelegislature.org/legis/statutes/5/title5sec4572.html

Age and gender discrimination is against the law and should be reported when found. Unum has been terminating elderly men, women and disabled employees for quite some time now.

 

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You're fired“Linda, would you please write a blog post about what happens when a claimant who has been fired by their employer who at first accommodated the employees restrictions and limitations then changed their mind. I had a job where I could make my own PT hours depending on my pain level each day but even though I can work PT no other employer is interested in such an arrangement. I do not qualify for SSDI yet my illnesses prevent me from finding employment .”

This is a very common Catch-22 position some claimants find themselves in. Unfortunately, employers have the upper hand when it comes to allowing or disallowing work accommodations. Neither FMLA nor ADA actually favors employees who need work accommodations in order to stay employed. Most employers want employees who are healthy enough to perform jobs as they should be performed on a regular basis and eventually will use any available employment laws to terminate employees at will.

The Family Medical Leave Act protects employee positions and benefits for a period of 12 weeks. At the end of the maximum FMLA period, employers can terminate employee employment and benefits with the blessing of the federal government.

Since FMLA is unpaid leave that runs consecutively with STD, most employees who can return to work on an accommodated basis, look to employers to approve “work accommodations”. Although the Americans with Disabilities Act requires employers to “reasonably” accommodate employees, ADA also gives employers a long list of “outs”, or reasons why it doesn’t have to accommodate employees at all.

Literally, the only choice claimants have when dealing with employers who are unwilling to accommodate is to find part-time jobs without accommodations that can be sustained on a long-term basis. We live in a very competitive work environment now, so it may not be easy to convince an employer to hire you part-time when the employer is looking to fill positions with healthy, dependable, full-time workers.

Bottom line, employers are NOT required (or, at least are given many legal outs) to provide (or not provide) workers with accommodations, particularly work-at-home options. Employers can’t exercise very much control over workers who remain at home and rarely approve work-at-home accommodations at full pay.

Now, I realize there will be people who will contact me expounding kudos as to how their employers are allowing them to work at home part-time. If your employer is doing this, that’s great, but realize any employer can pull the plug after 12 weeks of FMLA if they want to. There is no guarantee (absent an employment contract) of continued work accommodation.

The other side of this problem is what happens to the disability claim when your doctor continues to support  part-time capacity, but your employer pulled the plug on part-time accommodated work.

Read your policy carefully. Some policies actually contain provisions that allow claim terminations when claimants are given part-time work capacity, but aren’t working part-time. Many insurers will give employees 30 days to find part-time work before denying claims; others will terminate right away.

The only solution here is that claimants who cannot return to work without accommodations should discuss their realistic ability to work at all with their treating physicians. If there are no employment opportunities for work accommodations and you continue to have R&Ls requiring them, discussions need to take place between you and your physician to determine realistic alternatives such as R&Ls that preclude work all together.

In any event, situations involving continued employer work accommodations, particularly working at home are tenuous at best and should not be trusted to continued long-term. Eventually, employers tire of the hassle and want to hire others who are capable of filling job expectations and objectives.

Yes, there are some employers who are willing to accommodate their favored employees, but most others are not so lucky and find themselves looking for un-accommodated part-time work they won’t be able to medically sustain.

It’s a Catch-22 situation that is often difficult to manage and we strongly recommend claimants to their treating physicians who may be able to assist them.

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Business ConsultOccasionally, DCS receives calls from employers asking for advice in designing its disability benefit package offered to employees. In the course of speaking with various HR reps it became increasingly clear how little employers actually know about “group disability” and the uncertainty of future benefits.

Despite the extent of employer loyalty described to me by nearly every claimant, it’s clear that employers begin the disability process sympathetically, but quickly retreat to silence when it becomes clear employees will not be returning to work after the FMLA or STD period. The obvious goal or objective of any employer is to replace the absent employee with someone who can do the job as it is expected to be done.

Employers often do not do their homework in researching the history of various Group Plans to determine if insurers are acting within the scope of the NAIC (National Association of Insurance Commissioners) Model Acts, or how often state Conduct Market Examinations have found infringements resulting in the payment of fines.

What are the statistics of payment of claims versus claim denials? What kind of Customer Service will be offered to my employees? Does the insurance company accept recommendations from treating physicians? How will the insurance company review claims? What’s the process look like? Will the Plan contain provisions adverse to my employees? These are all-important questions that employers don’t ask before choosing group Plans.

Due to the fact that employers remain in the dark about Group Disability Plans they often do not know what questions to ask. For example, employers have the option of also requesting a “Service Contract” guaranteeing certain levels of claim acceptance and service to employees. Failure to live up to the agreed terms results in a return of paid premium to the employer. Annual audits of files determine the extent of compliance with the service contract.

However, it has always been my experience that most employers are looking to spend benefit dollars for the best low-cost Plan on the market even when ERISA employer-sponsored Plans aren’t the best options to choose for anyone. Readers may recall on this blog my comments that “Group Disability insurance is not to be depended on long-term for financial support.” There is a better way for employers to provide the opportunity for coverage without all of the adverse effects of the average ERISA policy.

First, employers who self-insure STD, whether it is integrated with FMLA or not, are making a good choice by retaining a third-party administrator to review short-term claims and make ATP (advice to pay) recommendations back to the employer. Since there are no financial reserves associated with STD as a general rule, STD most often results in approval decisions. Employees are given 12 weeks of un-paid FMLA leave and 26 weeks of STD to recover and return to work. The employer always has the last word on self-insured claims and can disagree with the insurance company and pay claims despite denial recommendations from the insurance company.

However, LTD is entirely a different matter. DCS does not recommend to employers that they purchase any group Plan from any insurer. Instead, we suggest that employers make it possible for employees to buy non-ERISA Disability Income Replacement Insurance offering employees the option of paying 100% of the premium. Since employees are paying premiums any benefits received are non-taxable and there are no adverse provisions such as changes in disability definition after 24 months, no SSDI or other offsets, and limitations for mental and nervous disabilities.

Employees can apply for and keep SSDI overpayments and may choose from a wide variety of other options such as COLA, Future Increase Options, Residual Disability and Lifetime benefit options. Employers benefit because employees are making investments in possible future outcomes and will have future control (as policy owners) over claims, privacy and communications. Mass Mutual, I’m told, offers DI policies to employees that are non-ERISA.

Most importantly, insured employees will own policies with state jurisdictions not subject to ERISA and can sue insurers for bad faith if necessary. While the original intent of ERISA was to protect employees it no longer does as a result of various court decisions favoring insurers.

Of course the negative side to employee DI insurance is cost. Although employers can negotiate premiums for national accounts somewhat DI insurance is not free the way non-contributory employer-provided group insurance is. Although most American employees depend on cost-free employer disability benefits, the ultimate results of increasing refusals by insurers to pay benefits makes Group Plans undependable sources of future income. “Something for nothing” in this case may very well result in “no benefits” when employees need them most.

Whether employees will recognize the value of premium investments in DI insurance remains to be seen. Employers who refuse to look for alternatives preferring the “cheapest” way to allocate employee benefit dollars aren’t doing employees any favors.

Regardless, the best disability coverage is self-insured STD followed by employee purchases of DI insurance coverage by paying 100% of the premium, perhaps through payroll deduction on an after-tax basis.

Employee investment in the premium of non-ERISA plans provides better coverage with decreased risks of adverse provision limitations, and unfair denials.

Filing claims on ERISA employer plans obtained for nothing often result in nothing on the long end when insurers deny legitimate claims that should be paid.

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